Immune Checkpoint Inhibitor-induced Polymyalgia Rheumatica - 24/04/24

Doi : 10.1016/j.rdc.2024.02.001

David F.L. Liew, MBBS ^a,^b,^c,^⁎ , Sarah L. Mackie, BMBCh, PhD ^d, Alice Tison, MD ^e,^f, Sebastian E. Sattui, MD ^g, Max Yates, MBBS, PhD ^h,ⁱ, Russell R.C. Buchanan, MD ^a,^c, Claire E. Owen, MBBS, PhD ^a,^c
^a Department of Rheumatology, Austin Health, Heidelberg West VIC 3081, Australia
^b Department of Clinical Pharmacology and Therapeutics, Austin Health, Heidelberg VIC 3084, Australia
^c Department of Medicine, University of Melbourne, Parkville, Victoria 3052, Australia
^d Division of Rheumatic and Musculoskeletal Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, Worsley Building, Leeds, West Yorkshire LS2 9NL, England
^e LBAI UMR1227, Univ Brest, Inserm, Brest, France
^f Department of Rheumatology, CHU Brest, France Boulevard TANGUY PRIGENT, Brest, Brittany 29609, France
^g Division of Rheumatology and Clinical Immunology, University of Pittsburgh, BST S723, 3500 Terrace Street, Pittsburgh, PA 15261, USA
^h Norwich Medical School, University of East Anglia, Norwich, UK
ⁱ Department of Rheumatology, Norfolk and Norwich University Hospital, Norwich, UK

^∗Corresponding author. Department of Rheumatology, Level 1, North Wing, Heidelberg Repatriation Hospital, 300 Waterdale Road, PO Box 5444, Heidelberg West VIC 3081, AustraliaDepartment of Rheumatology, Level 1, North Wing, Heidelberg Repatriation Hospital300 Waterdale Road, PO Box 5444HeidelbergWest VIC3081Australia

Résumé

Polymyalgia rheumatica (PMR) immune-related adverse events (ICI-PMRs) represent a novel, distinct entity, despite many clinical, laboratory, and imaging similarities to classical PMR. Important questions remain in differentiating ICI-PMR from classical PMR, as well as other immune-related adverse events and PMR mimics. Despite this, ICI-PMR currently takes treatment cues from classical PMR, albeit with considerations relevant to cancer immunotherapy. Comparisons between ICI-PMR and classical PMR may provide further bidirectional insights, especially given that important questions remain unanswered about both diseases. The cause of classical PMR remains poorly understood, and ICI-PMR may represent a model of induced PMR, with important therapeutic implications.

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Keywords : Polymyalgia rheumatica, Immune-related adverse event, Mimics, Paraneoplastic, Disease model, Peresolimab, PD-1 agonist, PD-1 inhibitor

Plan

Key points

Introduction

Immune checkpoint inhibitor’s foundations on current concepts of polymyalgia rheumatica

Mimics and triggers of classical polymyalgia rheumatica

Resemblance of immune checkpoint inhibitor-induced polymyalgia rheumatical to classical polymyalgia rheumatica

Unanswered questions

Defining polymyalgia rheumatica immune-related adverse events

Immune checkpoint inhibitor-induced polymyalgia rheumatica versus immune checkpoint inhibitor-induced inflammatory arthritis and other immune-related adverse events

Immune checkpoint inhibitor-induced polymyalgia rheumatica versus classical polymyalgia rheumatica

Immune checkpoint inhibitor-induced polymyalgia rheumatica versus the “polymyalgia rheumatica mimics”

Treatment

Shared decision-making between patient and clinician

Future prospects

Summary

Clinics care points

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Vol 50 - N° 2

P. 255-267 - mai 2024 Retour au numéro

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Immune Checkpoint Inhibitor-induced Polymyalgia Rheumatica - 24/04/24

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